SMSF Application Form - Wealth Gen Investor

Form
Required Documents
All documents below are required
Upload Company Statement or ASIC Extract

For Corporate Trustee only. Not required if SMSF is less than 12 months old.
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Upload SMSF Trust Deed - Cover Page

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Upload SMSF Trust Deed - Schedule Page

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Upload SMSF Trust Deed - Execution/Signature Pages

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Upload SMSF Trust Deed - Application for Membership Pages

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Financial Services Guide & Declarations
Before your account can be finalised, you must read, understand and accept the terms and conditions that apply. Download the FSG: https://cdn.prod.website-files.com/665e9fb0eb2aa008bdafcaaa/666fd0aae04bf10be29789f1_VFS-FSG-1May2024.pdf
I confirm I have read, understood and agree to the Financial Services Guide (FSG) and Terms and Conditions.
I confirm all information provided in this application is true, accurate and complete to the best of my knowledge.
I acknowledge the Privacy Collection Statement and consent to the collection, use and disclosure of personal information as described.
I consent to receiving marketing communications from Wealth Gen Investor.
Signature
Signature of Primary Account Holder
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Wealth Gen Investor - SMSF Account Application
Welcome to the Wealth Gen Investor SMSF account application. Please ensure all directors, trustees, members and beneficiaries' details are complete. Contact info@wealthgeninvestor.com if you need help. You can save and return to this application at any time before submitting.
What you'll need SMSF Trust Deed SMSF ABN and TFN ID for all directors/trustees/members/beneficiaries Individual TFNs Employment details Bank account details Residential addresses
SMSF Fund Details
Full legal name of the SMSF
SMSF ABN
SMSF TFN
Date the SMSF was established

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Trustee structure
Corporate Trustee company name
Corporate Trustee ACN
Is the SMSF an Australian Superannuation Fund for tax purposes?
Does the SMSF Trust Deed permit the types of investments to be made through this account?
SMSF bank account name
SMSF bank BSB
SMSF bank account number
SMSF bank name
Directors / Trustees & Members
How many Directors/Trustees does the SMSF have?
How many members does the SMSF have?
Is this a single-member fund?
Director / Trustee 1 Details
Full legal name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip CodeCountry
Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Email address
example@example.com
Occupation
Employer name
Director 1 Tax File Number
Is this person also a member of the SMSF?
Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Upload Drivers Licence

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Drivers Licence number
Drivers Licence state of issue
Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upload Passport or secondary proof of address

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Director / Trustee 2 Details
Director 2 Full legal name
Director 2 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 2 Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 2 Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Director 2 Email address
example@example.com
Director 2 Occupation
Director 2 Tax File Number
Director 2 Employer name
Director 2 Is this person also a member of the SMSF?
Director 2 Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Director 2 Upload Drivers Licence

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Director 2 Drivers Licence number
Director 2 Drivers Licence state of issue
Director 2 Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director / Trustee 3 Details
Director 3 Full legal name
Director 3 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 3 Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 3 Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Director 3 Email address
example@example.com
Director 3 Occupation
Director 3 Employer name
Director 3 Tax File Number
Director 3 Is this person also a member of the SMSF?
Director 3 Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Director 3 Upload Drivers Licence

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Director 3 Drivers Licence number
Director 2 Upload Passport or secondary proof of address

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Director 3 Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 3 Upload Passport or secondary proof of address

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Director 3 Drivers Licence state of issue
Director / Trustee 4 Details
Director 4 Full legal name
Director 4 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 4 Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 4 Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Director 4 Email address
example@example.com
Director 4 Occupation
Director 4 Employer name
Director 4 Tax File Number
Director 4 Is this person also a member of the SMSF?
Director 4 Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Director 4 Upload Drivers Licence

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Director 4 Drivers Licence number
Director 4 Drivers Licence state of issue
Director 4 Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 4 Upload Passport or secondary proof of address

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Director / Trustee 5 Details
Director 5 Full legal name
Director 5 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 5 Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 5 Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Director 5 Email address
example@example.com
Director 5 Occupation
Director 5 Employer name
Director 5 Tax File Number
Director 5 Is this person also a member of the SMSF?
Director 5 Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Director 5 Upload Drivers Licence

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Director 5 Drivers Licence number
Director 5 Drivers Licence state of issue
Director 5 Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director / Trustee 6 Details
Director 6 Full legal name
Director 6 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 6 Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 6 Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Director 6 Email address
example@example.com
Director 6 Occupation
Director 6 Employer name
Director 6 Tax File Number
Director 6 Is this person also a member of the SMSF?
Director 6 Is this person a Politically Exposed Person (PEP) or an immediate family member/close associate of one?
Director 6 Upload Drivers Licence

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Director 6 Drivers Licence number
Director 6 Drivers Licence state of issue
Director 6 Drivers Licence expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Director 6 Upload Passport or secondary proof of address

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Director 5 Upload Passport or secondary proof of address

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Beneficiaries
Are there beneficiaries who are NOT directors/trustees of the SMSF?
How many additional beneficiaries are there?
Beneficiary 1 Full legal name
Beneficiary 1 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficiary 1 Relationship to member
Beneficiary 1 Percentage of benefit (%)
Beneficiary 1 Type of nomination
Beneficiary 1 Upload Drivers Licence or Passport

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Beneficiary 1 Tax File Number
Beneficiary 2 Full legal name
Beneficiary 2 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficiary 2 Relationship to member
Beneficiary 2 Percentage of benefit (%)
Beneficiary 2 Type of nomination
Beneficiary 2 Upload Drivers Licence or Passport

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Beneficiary 2 Tax File Number
Beneficiary 3 Full legal name
Beneficiary 3 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficiary 3 Relationship to member
Beneficiary 3 Percentage of benefit (%)
Beneficiary 3 Type of nomination
Beneficiary 3 Upload Drivers Licence or Passport

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Beneficiary 3 Tax File Number
Beneficiary 4 Full legal name
Beneficiary 4 Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficiary 4 Relationship to member
Beneficiary 4 Percentage of benefit (%)
Beneficiary 4 Type of nomination
Beneficiary 4 Upload Drivers Licence or Passport

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Beneficiary 4 Tax File Number
Financial Information
Net Worth (AUD)
Liquid Net Worth (AUD)
Annual Net Income (AUD)
Source of funds for this SMSF account
If Other selected, please specify
Source of wealth
Investment experience
Regulatory & Compliance Questions
Are you or any immediate family member who resides in the same household registered as an employee, director or owner of an Australian Financial Services Licence (AFSL) holder, securities broker, bank, hedge fund, or other financial services company?
Is any director/member a director, 10% shareholder or policy-making officer of any publicly traded company?
If yes to the previous question, please list the company names
Is any director/member an employee, associated or affiliated person of ASIC, ASX, AUSTRAC or any other regulatory or self-regulatory organisation?
Has any director/member ever been the subject of an investigation or proceeding by ASIC, the ASX, AUSTRAC, or any other securities/commodities regulatory authority?
If yes to the previous question, please provide details
Does the SMSF qualify as a Wholesale Client under s761G of the Corporations Act 2001?
Security Questions
Nominate Security Question 1
Answer to Question 1
Nominate Security Question 2
Answer to Question 2
Nominate Security Question 3
Answer to Question 3
Primary Account Holder

The primary account holder must be a Director/Member or Trustee of the SMSF and will be the main point of contact.
Primary contact full name
Primary contact email
example@example.com
Primary contact mobile
Please enter a valid phone number.Format: (000) 000-0000.
Preferred contact method
Adviser / Accountant Details (Optional)
Is this application being submitted with the assistance of an adviser or accountant?
Adviser/Accountant name
Adviser/Accountant firm
Adviser/Accountant email
example@example.com
Adviser/Accountant phone
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Form

Required Documents

Financial Services Guide & Declarations

Signature

Wealth Gen Investor - SMSF Account Application

SMSF Fund Details

Directors / Trustees & Members

Director / Trustee 1 Details

Director / Trustee 2 Details

Director / Trustee 3 Details

Director / Trustee 4 Details

Director / Trustee 5 Details

Director / Trustee 6 Details

Beneficiaries

Financial Information

Regulatory & Compliance Questions

Security Questions

Primary Account Holder

Adviser / Accountant Details (Optional)